Role of Ultrasound Electrography in the Assessment of Breast Masses

Abstract

Author(s): Hussain Addai Aljabery, Dhaffer Abdullah Hawigi, Abdulameer Almosawi, Yosra Sahib, Qais Qassim Malik Alkhalil

The high incidence of breast cancer and its slow evolution before diagnosis have led to search for new diagnostic techniques. Sonographic elasticity imaging offers the potential to non-invasively characterize breast lesions. This study aimed to assess the role of ultrasonographic elastography in the differential diagnosis of breast masses. A total of 50 patients with palpable and non-palpable breast masses were examined by B-mode ultrasonography then sonographic elastography was done for evaluation of benign and malignant criteria of masses followed by FNAC or True-cut biopsy histopathology as a confirmatory test. All age groups presented with breast mass (palpable or nonpalpable). All patients who have documentary cytology or histopathology. FNA was performed in 29 women (54%), and true cut in 21(42%). Furthermore, FNA revealed 10(34.5%) malignant lesions (breast cancer) and 19(65.5%) were benign (fibro adenoma and breast abscess), on the other hand the true cut biopsies revealed 18(85.7%) malignant lesions and 3(14.3%) benign, these findings giving a total of 28 malignant lesions (56%) and 22(44%) benign among the studied group. There was a statistically significant association between the BIRAD score and malignancy, where the frequency of malignant lesions increased with the advanced BIRAD score, (P value<0.001). Furthermore, the BIRAD II and III were considered as benign and the BIRAD IV and V were considered as malignant and when compared to biopsy it had been found that sensitivity of BIRAD had a sensitivity of (82.1%), specificity (95.5%), PPV (95.8%), NPV (80.7%) and accuracy of (88%). Also when there is comparison of validity test of SR according to different cutoff point where it appear that the cutoff point 2.5 had the higher sensitivity (78.6%) & specificity (95.5%). From other point of view, the sensitivity, specificity, PPV, NPV and accuracy of BIRADs were (82.1%, 95.5%, 95.8%, 80.7% and 88%) respectively and when compared to that of SR with cut- off point 2.5 no statically significant difference had been formed in validity test between SR at this cut off point and BIRAD score. Ultrasound elastography is a simple, fast, and non-invasive technique, which can be performed immediately after conventional sonography. Used as a complementary technique in addition to B-mode sonography, it increases the diagnostic specificity for breast lesions, thus reducing the false-positive rate. Ultrasound elastography has a sensitivity and specificity equal or higher than conventional B-mode US examination.

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